Martin, Randall Lee

Martin, Randall Lee is an individual health care provider with primary practice located at 204 Mccollum Drive Suite 101, Laramie WY 82070. He recently has only one registered license in Allopathic & Osteopathic Physicians / Anesthesiology, which is considered as his primary health care specialty. Martin, Randall Lee can be contacted via phone (307) 745-6065.

Contact Information

Primary practice address
204 Mccollum Drive Suite 101 Laramie WY 82070
Phone: (307) 745-6065
Fax: (307) 745-4936
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Anesthesiology 207L00000X MD14891 Oregon
Allopathic & Osteopathic Physicians / Anesthesiology 207L00000X TL1962 Wyoming
Allopathic & Osteopathic Physicians / Anesthesiology 207L00000X 60771584 Washington

Profile Details

NPI number 1215955885
LBN Legal business name Martin, Randall Lee
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 18th, 2006
Last updated May 15th, 2018 - about 8 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1215955885 NPPES
Oregon MEDICAID 176917
Oregon MEDICAID 200948040

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